Gaming disorder refers to a condition involving excessive gaming behavior with negative life consequences. It’s not an official diagnosis—yet. The World Health Organization (WHO) is preparing to release its latest version of the International Classification of Diseases, the ICD-11 in May, 2019. Gaming disorder is included.

Further, the American Psychiatric Association (APA) included Internet gaming disorder as a condition for study in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The idea of an official diagnosis called gaming disorder and the possible inclusion of Internet gaming disorder in the next revision of the DSM has sparked heated debates. Here’s an overview of what gaming disorder is all about.

Gaming Disorder Statistics

Both the WHO and the APA are concerned about gaming activity. It seems to be addictive and harmful, and it potentially impacts a significant number of people.

Because this concept is newly emerging as a recognized clinical disorder, defining characteristics vary. This means that numbers are slightly different from study to study; still, a consistent pattern has already emerged.

• One large German study found that 1.5 to 3.5 percent of teens who play Internet games show signs of addiction (Conrad, n.d.; King, et al., 2010)
• A literature review conducted in 2011 found that six percent of gamers exhibited addiction patterns, but when the definition of addiction was adjusted, the percentage changed to just over three percent (Whittek, et al., 2016)

It’s becoming evident that approximately three percent of players become addicted and will meet the criteria for gaming disorder.

Definition and Consequences of Gaming Disorder

The WHO describes a number of defining characteristics of gaming disorder. It’s a pattern of digital video gaming behavior that is more than merely time spent gaming and involves

• Little control over the gaming
• Increasing priority is given to gaming
• Gaming behavior that overtakes other interests and activities
• Continued gaming despite negative consequences

Spending a lot of time playing video games, while not ideal, isn’t by itself a sign of addiction. To be a true addiction, the gaming activity must disrupt different aspects of someone’s life:

• Personal
• Family
• Social
• Educational
• Occupational
• Leisure
• Participation in other activities
• Sleep
• Self-care

Gaming addiction can harm physical and mental health, too. It’s associated with poor nutrition, lack of exercise, and vision and hearing difficulties. It’s also associated with depression, anxiety, social anxiety, and ADHD.

Gaming Disorder Symptoms

If you are wondering if you or someone you know might be addicted to video games, look for certain gaming addiction symptoms that will help you know if gaming is becoming a problem for you.

The three general symptoms to watch for include:

• Impaired control over gaming behavior, like having difficulty stopping or starting when you know you shouldn’t
• More and more, turning your attention to gaming rather than to other things and people
• Continued or intensified gaming despite negative consequences like the ones listed above                                                                                                                        

A common question researchers, gamers, and loved ones ask upon looking at the symptoms and negative consequences is why. Why does gaming addiction happen?

Causes of Gaming Addiction

Why are video games addicting? Gaming addiction is complex with several causes or contributing factors. Addiction can happen in part because of the nature of the games. Personality traits are at work as well. Mental health elements, too, play a part in whether someone develops a gaming addiction.

The games themselves are designed to hook people. They’re intentionally programmed using specific algorithms coupled with behavior economics to keep people playing.

Regarding personality traits and mental health as causes of gaming addiction, there’s a bit of a chicken-and-egg debate occurring. Do factors such as poor time management skills and mental health problems, like depression and anxiety, cause someone to be vulnerable to gaming addiction? Or, conversely, do gamers develop mental health problems because of their addiction? Or is it a mix of both? Research studies are underway to discover a reliable cause of addiction.

Treatment for Gaming Addiction

Gaming addiction is treatable. Here, too, researchers are trying to find the most effective treatment approaches for addicting games. These approaches have been shown to go far in helping people overcome this addiction:

• Cognitive behavioral therapy (CBT)
• Solution-focused therapy
• Interpersonal therapy (“talk therapy”)
• Psychoeducation

Of these, CBT is emerging as the most helpful approach in beating a gaming addiction.

While not everyone agrees with the inclusion of gaming disorder in the upcoming ICD-11 or the acknowledgment of Internet gaming disorder in the DSM-5, there are many benefits to adding this official diagnosis.

It could make some gamers more aware and willing to seek help if needed (Where to Find Help If You’re Addicted to Gaming). It could add this to the list of conditions insurance will cover.

Finally, the diagnosis of gaming disorder legitimizes the concern held by many that video games are taking over lives.

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Quitting heroin and getting into heroin treatment is a big decision, but it's also a big step forward to a healthier life. Quitting heroin may even seem impossible at times, but there are several treatments for heroin addiction that are designed to help someone quit heroin.

Medical heroin treatment may be required for:

• Heroin overdose
• Heroin withdrawal
• Long-term heroin addiction treatment

Estimates vary widely, but some estimate up to 97% of those getting treatment for heroin addiction will relapse.¹ The best heroin addiction treatments involve initial withdrawal from heroin under medical supervision and then heroin treatment in a therapeutic community residential program lasting 3 - 6 months.²

Heroin Treatment - Acute Treatment for Heroin

If under the influence of heroin when medical heroin addiction help is sought, the doctor will first determine if treatment for heroin overdose is required. The doctor may:

• Ensure breathing, with assistance if needed
• Provide IV fluids
• Monitor vital signs

Heroin treatment, when under the influence, also typically involves the administration of naloxone. Naloxone is an opioid receptor blocker that reverses the effects of heroin.

Heroin Treatment - Treatment for Heroin Withdrawal and Heroin Treatment Maintenance

Treatment for heroin withdrawal can be crucial to the success of heroin treatment as it's often the withdrawal pains that send an addict back to using heroin. While withdrawal is unpleasant and possibly painful, it is not life-threatening and there is treatment available for heroin withdrawal effects.

Heroin withdrawal begins 6 - 12 hours after heroin use, peaks at 1 - 3 days and subsides in 5 - 7 days. The first seven days of heroin withdrawal treatment is often done in a heroin treatment facility. Heroin withdrawal symptoms include:

• Sweating, cold sweats
• Mood changes like anxiety or depression
• Restlessness
• Cramps, severe muscle and bone aches
• Tears, running nose
• Insomnia
• Chills, Fever
• Nausea, vomiting, diarrhea
• And others

Treatment for heroin withdrawal can minimize these effects and shorten withdrawal time. Medication treatment for heroin addicts going through withdrawal includes:

• Clonidine - Reduces anxiety, agitation, muscle aches, sweating, runny nose, and cramping
• Buprenorphine - a pain medication that blocks withdrawal symptoms, thought to be the safest option with lower risk of addiction

Ongoing medication treatment for heroin addiction often includes buprenorphine, methadone or naltrexone:

• Methadone - reduces pain sensations and can be used during pregnancy
• Naltrexone - blocks the effects heroin

For medications used in heroin treatment, the ultimate goal is to discontinue them completely. Maintenance treatment for heroin addiction often tapers off these medications very slowly to avoid withdrawal pain.

Heroin Treatment - Non-medication Treatment of Heroin Addiction

While heroin addiction treatment almost always includes some medication, the best chance at long-lasting recovery is the inclusion of behavioral heroin treatments. Both residential and outpatient heroin treatments are available.

Heroin treatment therapies include:

• Contingency management therapy - a system where addicts earn "points" for drug-free screenings. These points can then be exchanged for items that encourage healthy living.
• Cognitive behavioral therapy - designed to challenge the thoughts and actions associated with drug use. Stress-tolerance and life skills are taught to encourage a new way of approaching everyday life.

Heroin treatment also frequently includes group therapy or support either in a heroin rehab center or in a community group such as Narcotics Anonymous or SMART Recovery. Being around others also quitting heroin can be key to successful heroin treatment.

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A Commentary by Enoch Gordis, M.D., Director of the National Institute on Alcohol Abuse and Alcoholism

The primary goal of alcoholism treatment, as in other areas of medicine, is to help the patient to achieve and maintain long-term remission of disease. For alcohol addicts, remission means the continuous maintenance of sobriety. There is continuing and growing concern among clinicians about the high rate of relapse among their alcoholic patients, and the increasingly adverse consequences of continuing disease. For this reason, preventing relapse is, perhaps, the fundamental issue in alcoholism treatment today.

Modern science, both biological and behavioral, has explored a number of different leads in the quest to prevent relapse. These range from pharmacological agents, such as the serotonin uptake blockers and disulfiram, to behavior constructs, such as cue extinction and skills training. Although these are promising leads that one day may improve significantly the chances of alcohol dependent persons to continue long-term sobriety, there are no definitive answers yet to this troubling aspect of alcoholism treatment.

For example, the interesting work on pharmacological agents to help prevent relapse evolved from the study of brain receptors and suggests that serotonin may diminish an alcoholic's desire or craving for alcohol. This research, however, must be confirmed by properly conducted controlled clinical trials before widespread application to treating alcohol dependency. Similarly, behavioral approaches have been well described by the talented scientists who undertook the initial studies; however, evidence of the effectiveness of these approaches in preventing relapse in dependent drinkers has not been documented in adequate controlled trials.

Although we are not yet at the point where we can state definitively what works best in preventing relapse, I firmly believe that we are on the brink of a new period in alcoholism treatment research that ultimately will help us to develop this knowledge. For the present, therapists should examine critically the evidence for new nonpharmacological approaches before initiating them. Similarly, good clinical wisdom should discourage the use of unproven pharmacological agents to prevent alcoholism relapse until the efficacy of using such agents in this regard is proven.

Other Alcohol Relapse Articles

• Start of A Drinking Relapse
• Signs and Symptoms of Alcoholic Relapse
• 10 Most Common Dangers That Can Lead to a Alcohol or Drug Relapse
• Attitudes That Can Lead to a Drug or Alcohol Relapse
• Preventing an Alcohol Relapse

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Relapse is a progressive process of becoming so dysfunctional in recovery that self-medication with alcohol or drugs seems like a reasonable choice.

Many people who relapse say that when they took the first drinks/drugs, it seemed that they were on automatic pilot, as though they were in a film and couldn't even seem to watch themselves disinterestedly from outside as they walked in the bar, opened the bottle or reached for the joint/needle.

According to the National Institute on Alcohol Abuse and Alcoholism, it only takes one or two drinks or drugs to inevitably lead back to massive drinking within a short period.

Relapse is an ever-present threat and part of the general recovery process for the majority of alcohol addicts. Many alcoholics, 80-90 percent, experience one or more relapses before achieving lasting sobriety. A minority manage to have none at all.

In order for an individual to prevent a drinking relapse, they must make a decision to comply with the alcoholism treatment regimen. "Research shows us that lack of treatment for alcoholism or alcoholism rehab compliance is the main cause for relapse among alcoholics," says Jonathan Huttner, of Lakeview Health Systems, an addiction treatment, alcohol and drug rehab center. Few recovering addicts or alcoholics fully realize just how diligent they have to become in following addiction treatment or rehab suggestions in order to maintain long term recovery from alcoholism.

Sources:

• National Institute on Alcohol Abuse and Alcoholism

See Also:

• Alcohol Relapse and Craving
• Start of A Drinking Relapse
• Signs and Symptoms of Alcoholic Relapse
• 10 Most Common Dangers That Can Lead to a Alcohol or Drug Relapse
• Attitudes That Can Lead to a Drug or Alcohol Relapse
• Preventing an Alcohol Relapse

article references

Many need food addiction help when it comes to food addiction recovery. Information for food addicts in recovery.

Basis of Food Addiction Recovery

Refined, processed foods trigger the addictive response in people who are genetically predisposed to the disease of addiction to food. If you don't think carbohydrates are mood-altering, think back to a big, heavy Thanksgiving dinner. You may have felt sleepy or lethargic afterward. Possibly you experienced a depressed mood or irritability.

Therefore, food addiction recovery is built upon making appropriate food choices on a daily basis. "Since food addicts in recovery have to eat every day, there is an ongoing need to check the content of the food eaten with the goal to use only food that is free of substances that will trigger the disease," says food addiction treatment specialist, Kay Sheppard, M.A. The result of good food choices is a body free of all substances that will trigger an addictive response.

Food Addiction Help: Abstinence is Key

Abstinence, according to Sheppard, is planning what to eat and eating what is planned. This is the foundation of food addiction recovery upon which a successful life is built.

Abstinence is achieved by the elimination of compulsive eating, volume eating, under eating, addictive eating, and all of the substances that will trigger an addictive response. These include highly refined carbohydrate foods, high-fat foods, and personal trigger foods.

Sheppard advises people who want food addiction help to take a look at the addictive substances in a general way.

• All addictive substances have gone through the refinement process.
• All addictive substances are quickly absorbed.
• All addictive substances alter brain chemistry.
• All addictive substances change mood.

Where Food Addicts in Recovery Can Get Food Addiction Help

Several options are available in the treatment of food addiction. These include consulting a nutritionist, doctor, psychologist, counselor, or eating disorder specialist. In addition, 12-step groups, such Overeaters Anonymous (OA) and Food Addicts in Recovery Anonymous, have meetings in many regions or online. Some tips for avoiding bouts of compulsive eating include:

• Knowing which situations trigger your cravings and avoiding them if possible
• Drinking at least 64 ounces of water per day
• Exercising
• Relaxing with deep breathing exercises or meditation
• Trying to distract yourself until the compulsion to eat passes

If you believe that your food or eating addiction is causing problems in your life, seek medical assistance immediately.

Sources:

• Cleveland Clinic
• Kay Sheppard, M.A., food addiction specialist and author of Food Addiction: The Body Knows and From the First Bite: A Complete Guide to Recovery from Food Addiction.

While heroin withdrawal is unpleasant or even painful, it is not normally life-threatening. Some heroin addicts experience heroin withdrawal on a regular basis when they cannot get the drug, or some experience heroin withdrawal by choice when they choose to seek treatment for heroin addiction.

Heroin withdrawal typically starts 6 - 12 hours after the last dose of heroin and heroin withdrawal symptoms tend to peak at 1 - 3 days after the last use of heroin. Most effects of heroin withdrawal subside in up to 5 - 7 days, but some heroin users may experience heroin withdrawal symptoms for weeks or even months. This protracted heroin withdrawal is known as post-acute withdrawal syndrome.¹

Heroin Withdrawal - Symptoms of Heroin Withdrawal

Perhaps the most unpleasant heroin withdrawal symptom is the strong desire to use heroin again. This desire is known as a craving. Craving happens during heroin withdrawal both because the user wants to feel the high of the drug and because they wish to stop the unpleasant heroin withdrawal symptoms.

Other symptoms of heroin withdrawal include:²

• Sweating, cold sweats
• Mood changes like anxiety or depression
• Restlessness
• Sensitization of genitals
• Feeling of heaviness
• Cramps in the limbs or abdomen
• Excessive yawning or sneezing
• Tears, running nose
• Insomnia
• Chills, Fever
• Severe muscle and bone aches
• Nausea, vomiting, diarrhea

Heroin Withdrawal - Managing Symptoms of Heroin Withdrawal

Heroin withdrawal should be done under medical supervision. Heroin withdrawal is often done in a heroin treatment center or hospital. Medical management of heroin withdrawal can reduce the symptoms of heroin withdrawal, often including that of cravings. Management of heroin withdrawal symptoms should include behavioral therapies, support of loved ones as well as medical management. For some addicts, heroin withdrawal symptoms are best managed in a treatment center where they can receive medical attention and support 24-hours a day.

Management of heroin withdrawal symptoms can be done with the following medications:³

• Clonidine - Reduces anxiety, agitation, muscle aches, sweating, runny nose and cramping
• Buprenorphine - a pain medication that blocks withdrawal symptoms, thought to be the safest option with lower risk of addiction
• Methadone - reduces pain sensations and is often used in long-term addiction maintenance programs
• Naltrexone - blocks the effects heroin, generally only used once the person has been heroin-free for several days

article references

There is evidence that approximately 90 percent of alcoholics are likely to experience at least one relapse over the 4-year period following alcohol abuse treatment (1). Despite some promising leads, no controlled studies definitively have shown any single or combined intervention that prevents relapse in a fairly predictable manner. Thus, relapse as a central issue of alcoholism treatment warrants further study.

Similar relapse rates for alcohol, nicotine, and heroin addiction suggest that the relapse mechanism for many addictive disorders may share common biochemical, behavioral, or cognitive components (2,3). Thus, integrating relapse data for different addictive disorders may provide new perspectives for relapse prevention.

Impaired control has been suggested as a determinant for relapse, yet is defined differently among investigators. Keller (4) suggested that impaired control has two meanings: the unpredictability of an alcoholic's choice to refrain from the first drink and the inability to stop drinking once started. Other investigators (5,6,7,8) limit the use of "impaired control" to the inability to stop drinking once started. They suggest that one drink does not lead inevitably to uncontrolled drinking. Research has shown that the severity of dependence affects the ability to stop drinking after the first drink (9,8,10).

Several relapse theories utilize the concept of craving. Use of the term "craving" in a variety of contexts, however, has led to confusion about its definition. Some behavioral researchers argue that the idea of craving is circular, hence meaningless since, in their view, craving can only be recognized retrospectively by the fact that the subject drank (11).

Some Reasons for an Alcohol Relapse

Craving for Alcohol

They deemphasize physiological urges and stress the relationship between the behavior of drinking and environmental stimuli that prompt the behavior. On the other hand, Ludwig and Stark (5) find no problem with the term "craving": craving is recognized simply by asking whether a subject who has not yet drunk alcohol feels a need for it, much as one can inquire about another person's hunger before he or she eats. Ludwig and associates suggested that alcoholics experience classical conditioning (Pavlovian), by pairing external (e.g., familiar bar) and internal (e.g., negative mood states) stimuli to the reinforcing effects of alcohol (5,12,6)

This theory suggests that craving for alcohol is an appetitive urge, similar to hunger, that varies in intensity and is characterized by withdrawal-like symptoms. The symptoms are elicited by internal and external cues that evoke the memory of the euphoric effects of alcohol and of the discomfort of alcohol withdrawal.

Physiological responses to alcohol cues have been described. For example, research has shown that exposure to alcohol, without consumption, can stimulate an increased salivary response in alcoholics (13). Similarly, skin conductance levels and self-reported desire for alcohol were correlated for alcoholic subjects in response to alcohol cues (14); the relationship was strongest for those most severely dependent. Alcoholics demonstrated significantly greater and more rapid insulin and glucose responses than nonalcoholics following the consumption of a placebo beer (15).

Several relapse prevention models incorporate the concept of self-efficacy (16), which states that an individual's expectations about his or her ability to cope in a situation will affect the outcome. According to Marlatt and colleagues (17,18,3), the transition from the initial drink following abstinence (lapse) to excessive drinking (relapse) is influenced by an individual's perception of and reaction to the first drink.

High-Risk Situations

These investigators formulated a cognitive-behavioral analysis of relapse, positing that relapse is influenced by the interaction of conditioned high-risk environmental situations, skills to cope with the high-risk situations, level of perceived personal control (self-efficacy), and the anticipated positive effects of alcohol.

An analysis of 48 episodes revealed that most relapses were associated with three high-risk situations: (1) frustration and anger, (2) social pressure, and (3) interpersonal temptation (17). Cooney and associates (19) supported this model by demonstrating that, among alcoholics, exposure to alcohol cues was followed by diminished confidence in the ability to resist drinking.

Marlatt and Gordon (3,20) argue that an alcoholic must assume an active role in changing drinking behavior. Marlatt advises the individual to achieve three basic goals: modify lifestyle to enhance the ability to cope with stress and high-risk situations (increase self-efficacy); identify and respond appropriately to internal and external cues that serve as relapse warning signals; and implement self-control strategies to reduce the risk of relapse in any situation.

Rankin and colleagues (21 ) tested the effectiveness of cue exposure in extinguishing craving in alcoholics. The investigators gave severely dependent alcoholic volunteers a priming dose of alcohol, which had been shown to evoke craving (22). Volunteers were urged to refuse further alcohol; their craving for more alcohol diminished with each session.

Preventing an Alcohol Relapse

Skills-Training Intervention

After six sessions, the priming effect almost completely disappeared. Volunteers who participated in imaginal cue exposure did not have the same outcome. This treatment was performed in a controlled, inpatient setting; the long-term effectiveness of cue exposure for diminishing craving after discharge remains to be demonstrated.

Chaney and associates (23) investigated the effectiveness of a skills-training intervention to help alcoholics cope with relapse risk. The alcoholics learned problem-solving skills and rehearsed alternative behaviors for specific high-risk situations. The investigators suggested that skills training may be a useful component of a multimodal behavioral approach to preventing relapse.A relapse prevention model for alcoholics (24) emphasizes a strategy that helps each individual develop a profile of past drinking behavior and current expectations about high-risk situations. The therapy for alcoholism promotes use of coping strategies and behavioral change by engaging the patient in performance-based homework assignments related to high-risk situations.

Preliminary outcome data revealed a decrease in the number of drinks consumed per day as well as in drinking days per week. Forty-seven percent of the clients reported total abstinence over the 3-month follow-up period, and 29 percent reported total abstinence over the entire 6-month follow-up period (25).

Disulfiram and Decreased Serotonin and Craving for Alcohol

Disulfiram is used as an adjunct to enhance the probability of long-term sobriety. Although patient compliance is problematic, disulfiram therapy has successfully decreased the frequency of drinking in alcohol addicts who could not remain abstinent (26). A study of supervised disulfiram administration (27) reported significant periods of sobriety of up to 12 months in 60 percent of patients treated.

Preliminary neurochemical studies have revealed that decreased levels of brain serotonin may influence appetite for alcohol. Alcohol-preferring rats have lower levels of serotonin in various regions of the brain (28). In addition, drugs that increase brain serotonin activity reduce alcohol consumption in rodents (29,30).

Four studies have evaluated the effect of serotonin blockers--zimelidine, citalopram, and fluoxetine on alcohol consumption in humans, each using a double-blind, placebo-controlled design (31,32,30,33). These agents produced a decrease in alcohol intake and, in some cases, a significant increase in the number of abstinent days. These effects, however, were found among small samples and were short-lived. Controlled trials in larger dependent populations are needed before serotonin blockers can provide hope as a possible adjunct for relapse prevention.

In both pharmacological and behavioral prevention strategies, it is important to consider the severity of alcohol dependence as a critical factor (9,10,20).

See Also:

• Alcohol Relapse and Craving
• Start of A Drinking Relapse
• Signs and Symptoms of Alcoholic Relapse
• 10 Most Common Dangers That Can Lead to a Alcohol or Drug Relapse
• Attitudes That Can Lead to a Drug or Alcohol Relapse
• Preventing an Alcohol Relapse

References

(1) POLICH, J.M.; Armor, D.J.; and Braiker, H.B. Stability and change in drinking patterns. In: The Course of Alcoholism: Four Years After Treatment. New York: John Wiley & Sons, 1981. pp. 159-200.

(2) HUNT, W.A.;Barnett, L.W.; and Branch, L.G. Relapse rates in addictions programs. Journal of Clinical Psychology 27:455-456, 1971.

(3) MARLATT, G.A. & Gordon, J.R. Determinants of relapse: Implications of the maintenance of behavior change. In: Davidson, P.O., and Davidson, S.M., eds. Behavioral Medicine: Changing Health Lifestyle. New York: Brunner/Mazel, 1980. pp.410-452.

(4) KELLER, M. On the loss-of-control phenomenon in alcoholism, British Journal of Addiction 67:153-166, 1972.

(5) LUDWIG, A.M. & Stark, L.H. Alcohol craving: Subjective and situational aspects. Quarterly Journal of Studies on Alcohol 35(3):899-905, 1974.

(6) LUDWIG, A.M.; Wikler A.; and Stark, L.H. The first drink: Psychological aspects of craving. Archives of General Psychiatry 30(4)539-547, 1974.

(7) LUDWIG, A.M.; Bendfeldt, F.; Wikler, A.; and Cain, R.B. Loss of control in alcoholic s. Archives of General Psychiatry 35(3)370-373, 1978.

(8) HODGSON, R.J. Degrees of dependence and their significance. In: Sandler, M., ed. Psychopharmacology of Alcohol. New York: Raven Press, 1980. pp. 171-177.

(9) HODGSON, R.; Rankine, H.; and Stockwell, T. Alcohol dependence and the priming effect. Behaviour Research and Therapy 17:379-3-87, 1979.

(10) TOCKWELL, T.R.; Hodgson, R.J.; Rankine, H.J.; and Taylor, C. Alcohol dependence, beliefs and the priming effect. Behavior Research and Therapy 20(5):513-522.

(11) MELLO, N.K. A Semantic aspect of alcoholism. In: Cappell, H.D., and LeBlanc, A.E., eds. Biological and Behavioural Approaches to Drug Dependence. Toronto: Addiction Research Foundation, 1975.

(12) LUDWING, A.M. & Wikle,. A. "Craving" and relapse to drink. Quarterly Journal of Studies on Alcohol 35:108-130, 1974.

(13) POMERLEAU, O.F.; Fertig, J.; Baker, L.; and Conney, N. Reactivity to alcohol cues in alcoholics and nonalcoholics: Implications for a stimulus control analysis of drinking. Addictive Behaviors 8:1-10, 1983.

(14) KAPLAN, R.F.; Meyer, R.E.; and Stroebel, C.F. Alcohol dependence and responsibility to an ethanol stimulus as predictors of alcohol consumption. British Journal of Addiction 78:259-267, 1983.

(15) DOLINSKY, Z.S.; Morse, D.E.; Kaplan, R.F.; Meyer, R.E.; Corry D.; and Pomerleas, O.F. Neuroendocrine, psychophysiological and subjective reactivity to an alcohol placebo in male alcoholic patients. Alcoholism: Clinical and Experimental Research 11(3):296-300, 1987.

(16) BANDURA, A. Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review 84:191-215, 1977.

(17) MARLATT, G.A. Craving for alcohol, loss of control, and relapse: A cognitive-behavioral analysis. In: Nathan, P.E.; Marlatt, G.A.; and Loberg, T., eds. Alcoholism: New Directions in Behavioral Research and Treatment. New York: Plenum Press, 1978. pp. 271-314.

(18) CUMMINGS, C.; Gordon, J.R.; and Marlatt, G.A. Relapse: Prevention and prediction. In: Miller, W.R., ed. The Addictive Behaviors: Treatment of Alcoholism, Drug Abuse, Smoking and Obesity. New York: Pergamon Press, 1980. pp. 291-321.

(19) CONNEY, N.L.; Gillespie, R.A.; Baker, L.H.; and Kaplan, R.F. Cognitive changes after alcohol cue exposure, Journal of Consulting and Clinical Psychology 55(2):150-155, 1987.

(20) MARLATT, G.A. & Gordon, J.R. eds. Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors. New York Guilford Press, 1985.

(21) RANKINE, H.; Hodgson, R.; and Stockwell, T. Cue exposure and response prevention with alcoholics: A controlled trial. Behaviour Research and Therapy 21(4)435-446, 1983.

(22) RANKINE, H.; Hodgson, R.; and Stockwell, T. The concept of craving and its measurement. Behaviour Research and Therapy 17:389-396, 1979.

(23) CHANEY, E.F.; O'Leary, M.R.; and Marlatt, G.A.Skills training with alcoholics. Journal of Consulting and Clinical Psychology 46(5):1092-1104, 1978.

(24) ANNIS, H.M. A relapse prevention model for treatment of alcoholics. In: Miller, W.R., and Healther, N., eds. Treating Addictive Disorders: Processes of Change. New York: Plenum Press, 1986. pp. 407-433.

(25) ANNIS, H.M. & Davis, C.S. Self-efficacy and the prevention of alcoholic relapse: Initial findings from a treatment trial. In: Baker, T.B., and Cannon, D.S., eds. Assessment and Treatment of Addictive Disorders. New York: Praeger Publishers, 1988. pp. 88-112.

(26) FULLER, R.K.; Branchey, L.; Brightwell, D.R.; Derman, R.M.; Emrick, C.D.; Iber, F.L.; James, K.E.; Lacoursier, R.B.; Lee, K.K.; Lowenstaum, I.; Maany, I.; Neiderhiser, D.; Nocks, J.J.; and Shaw, S. Disulfiram treatment of alcoholism: A Veteran Administration cooperative study. Journal of the American Medical Association 256(11):1449-1455, 1986.

(27) SERENY, G.; Sharma, V.; Holt, J. ; and Gordis, E. Mandatory supervised antabuse therapy in an outpatient alcoholism program: A pilot study. Alcoholism (NY) 10:290-292, 1986.

(28) MURPHY, J.M.; McBride, W.J.; Lumeng, L.; and Li, T.-K. Regional brain levels of monoamines in alcohol-preferring and nonpreferring lines of rats. Pharmacology, Biochemistry and Behavior

(29) AMIT, Z.; Sutherland, E.A.; Gill, K.; and Ogren, S.O. Zimelidine: A review of its effects on ethanol consumption. Neuroscience and Biobehavioral Reviews

(30) NARANJO, C.A.; Sellers, E.M., and Lawrin, M.P. Modulation of ethanol intake by serotonin uptake inhibitors. Journal of Clinical Psychiatry

(31) AMIT, Z.; Brown, Z.; Sutherland, A.; Rockman, G.; Gill, K.; and Selvaggi, N. Reduction in alcohol intake in humans as a function of treatment with zimelidine: Implications for treatment. In: Naranjo, C.A., and Sellers, E.M., eds. Research Advances in New Psycho-pharmacological Treatments for Alcoholism.

(32) NARANJO, C.A.; Sellers, E.M.; Roach, C.A.; Woodley, D.V.; Sanchez-Craig, M.; and Sykora, K. Zimelidine-induced variations in alcohol intake by nondepresssed heavy drinkers. Clinical Pharmacology and Therapeutics

(33) GORELICK, D.A. Effect of fluoxetine on alcohol consumption in male alcoholics. Alcoholism: Clinical and Experimental Research 10:13, 1986.

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Some kids seem addicted to online Internet use. If your child is developing into an online addict, here are a few simple ways to help your children reduce their time on the Internet and computer.

As a parent, are you concerned that your child may be developing an addiction to the internet and becoming an online addict?

If your kids are spending too much time online, you need to establish a healthy balance between Internet use and other activities.

How to Keep Your Child From Becoming An Online Addict

• Look for symptoms of Internet dependency. Ask yourself if your child's Internet use is affecting his or her school performance, health, and relationships with family and friends.
• If your child is demonstrating strong signs of Internet addiction, consider seeking professional counseling. Compulsive Internet use may be symptomatic of other problems such as depression, anger, and low self-esteem. (read about Internet Addiction Causes)
• Examine your own online habits. Do you have trouble controlling your Internet use? Are you an online addict? Remember, you are your child's most important role model.
• Don't ban the Internet - it is an important part of most kids' social lives. Instead, establish rules about where your kids can go online and what they can do there - and stick to them. Such rules might include: a limited amount of time online each day; no surfing or instant messaging until they complete their homework. Rules definitely help. In 2005, Media Awareness Network surveyed students in Grades 4 to 11 and found that kids who don't have a rule about how much time they can be on the Internet report 95 percent more online activity than kids who have a rule in place.
• Keep your computer in a public area of your house, not in a child's bedroom.
• Encourage and support your child's participation in other activities - particularly physical pastimes with other children.
• If your child is shy or socially awkward with peers, consider a social skills class. Encourage activities that will bring your child together with others who have similar interests, such as computer classes or hobby groups.
• Investigate software that monitors and restricts Internet use. Although these tools are helpful, keep in mind they can be easily disabled by a savvy computer user. Your ultimate goal should be helping your kids to develop self-control, discipline, and accountability with the Internet.
• If your child seems interested only in playing online video games, try a tie-in to one of their favorite games. For example, if your child prefers fantasy role-playing, encourage her or him to read fantasy books.

The compulsive gambler will do anything to spend more time gambling and the impact can be huge.

Pathological gambling affects the gambler, their family, their employer and the community. As the gambler goes through the phases of their addiction as previously mentioned, they spend less time with their family, spend more of the family's money on gambling until their bank accounts are depleted and then may steal money from family members.

At work, the compulsive gambler misuses time in order to gamble, has difficulty concentrating and finishing projects, may show abnormal mood swings and may engage in embezzlement, employee theft, or other illegal activities.

It's important to recognize the behaviors and attitudes that can lead to an alcohol relapse or hurt your recovery from alcohol or drug addiction.

If you are still in addiction recovery and any of these thoughts start swirling around in your head, run, don't walk, do not pass go, head right to the nearest 12 step meeting, call your counselor or someone who knows your story.

This type of addictive thinking is the beginning of the relapse process, and your job is to interrupt and not act on these destructive thoughts. 

• Sobriety is boring.
• I'll never drink/use again after this one time.
• I can do it myself. I'm not as bad as ___.
• I owe this one to me.
• My problems can't be solved.
• I wish I was happy.
• I don't care.
• If nobody else cares, why should I?
• Things have changed.
• I can substitute.
• They don't know what they are talking about.
• There's got to be a better way.
• I can't change the way I think.
• If I move, everything will change. I like my old friends.
• Nobody needs to know how I feel.
• I'm depressed.
• I feel hopeless.
• I can handle it.
• If I hide behind everyone else's problems, I won't have to face my own.
• I can't do it, so why try?

See Also:

• Alcohol Relapse and Craving
• Start of A Drinking Relapse
• Signs and Symptoms of Alcoholic Relapse
• 10 Most Common Dangers That Can Lead to a Alcohol or Drug Relapse
• Attitudes That Can Lead to a Drug or Alcohol Relapse
• Preventing an Alcohol Relapse

Sources:

• Support Systems Homes website